Insurance News:

Get Ready Now: Assess How ICD-10 Will Affect Your Practice

by Centers for Medicare and Medicaid Services | 9/2/2015 3:46:25 PM

With ICD-10 just 30 days away, now is the time to get ready. You can make sure your practice is prepared by following the ABCs of ICD-10:

  • Assess how ICD-10 will affect your practice and make a plan
  • Be sure your systems are ready
  • Contact your vendors

Today, we’ll explore “A” – “Assess how ICD-10 will affect your practice.”

“A” – “Assess how ICD-10 will affect your practice.”

As part of assessing how ICD-10 affects your practice, you should find out if you need:

Access to ICD-10 codes – You can find codes from a variety of sources, including:

Clearinghouse services – Some providers who are not ready could benefit from contracting with a clearinghouse to submit claims.

  • Clearinghouses can help by:
    • Identifying problems that lead to claims being rejected
    • Providing guidance about how to fix rejected claims (e.g., more or different data need to be included)
  • Clearinghouses cannot help you code in ICD-10 codes unless they offer third-party billing/coding services.

Clinical documentation and coding training

  • Train staff on ICD-10 fundamentals using the wealth of free resources from CMS, which include the ICD-10 websiteRoad to 10Email UpdatesNational Provider Calls, and webinars. Free resources are also available from:
    • Medical societies, health care professional associations
    • Hospitals, health systems, health plans, vendors
  • Training for clinical staff—e.g., physicians, nurse practitioners, physician assistants, registered nurses—should focus on documentation, new coding concepts captured in ICD-10.
  • Training for coding and administrative staff—e.g., coders, billers, practice managers—should focus on ICD-10 fundamentals.

New forms – It is crucial to update hard-copy and electronic forms (e.g., superbills, CMS 1500 forms).

Systems upgrades – Double check that you’ve identified all systems that use ICD codes and need upgrades (e.g., practice management systems, electronic health record (EHR) products).

  • Call your vendors to confirm the ICD-10 readiness of your practice’s systems
  • Confirm that the health plans, clearinghouses, and third-party billing services you work with are ICD-10 ready
  • Ask vendors, health plans, clearinghouses, and third-party billers about testing opportunities
  • Transition costs for small medical practices could be substantially lower than projected earlier:
    • Many EHR vendors are including ICD-10 in their systems or upgrades—at little or no cost to their customers
    • Software and systems costs for ICD-10 could be minimal for many providers

Keep Up to Date on ICD-10
Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources to help you prepare. Sign up for CMS ICD-10 Email Updates and follow us on Twitter.

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